Association between alcohol consumption patterns and poor dietary quality: a Korean nationwide cross-sectional survey

High dietary quality is essential for reducing the risk of chronic diseases; however, alcohol consumption has been associated with poorer dietary quality. Korea exhibits higher alcohol consumption prevalence and per-capita intake than the global average and has distinctive drinking patterns. Nevertheless, evidence regarding the association between alcohol consumption and dietary quality among Korean adults remains limited. In addition, previous studies have primarily evaluated alcohol consumption using specific dimensions of drinking behavior. Therefore, this study comprehensively examined the association between alcohol consumption and dietary quality among Korean adults using recent nationally representative data. This study included 10,019 participants aged ≥ 19 years from the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Alcohol consumption was assessed by total intake, beverage type, harmful drinking behavior using the Alcohol Use Disorders Identification Test (AUDIT), and binge drinking status. Dietary quality was evaluated using the validated Korean Healthy Eating Index (KHEI). Statistical analyses applied sampling weights and multivariable logistic regression models adjusted for potential confounders. Of all participants, 75.6% were current drinkers, including 57.2% light drinkers, 8.4% moderate drinkers, and 10.0% heavy drinkers. Compared with never drinkers, moderate and heavy drinkers had significantly higher odds of having poor dietary quality, with multivariable-adjusted odds ratios of 1.89 (95% confidence interval: 1.26–2.82) and 2.37 (1.64–3.42), respectively. Each additional serving of alcohol drinking (14 g of ethanol) was associated with a 23% increase in the odds of having poor dietary quality. Major types of alcoholic beverages were consistently associated with higher odds of having poor dietary quality among participants with beverage-specific information. Each one-point increase in the AUDIT score was associated with a 3% higher odds of having poor dietary quality. Moderate-to-heavy drinkers were more likely to have poor dietary quality. Moreover, both higher alcohol consumption and greater harmful drinking behavior (AUDIT scores) were positively associated with poor dietary quality. This positive association was generally consistent across the major beverage types among those with beverage-specific information. Not applicable.